Mixed Race Studies

Colour Coded Health Care: The Impact of Race and Racism on Canadians’ Health

Wellesly Institute: advancing urban health
Toronto, Ontario, Canada
January 2012
30 pages

Sheryl Nestel, Ph.D.

Scope and Purpose of the Review

Canada is home to a much-admired system of universal health care, understood as a central pillar of this nation’s overall commitment to principles of social equity and social justice. Such an understanding makes it difficult to raise the issue of racial inequities within the context of the Canadian health-care system. Indeed, as a number of Canadian health scholars have argued, with the exception of the substantial data on First Nations health, very little research has been conducted in Canada on racial inequality in health and health care (Health Canada, 2001; Johnson, Bottorff, Hilton, & Grewell, 2002; O’Neill & O’Neill, 2007; Rodney & Copeland, 2009). This literature review attempts to bring together data published between 1990 and 2011 on racial inequities in the health of non-Aboriginal racialized people in Canada. The decision not to include data on Aboriginal people in this review is by no means intended to obscure or minimize the appalling health conditions among Aboriginal people and the central role of colonialism and racism in their creation and perpetuation. It is clear, as Kelm (2005) has argued, that “social and economic deprivation, physical, sexual, cultural and spiritual abuse” (p. 397) underlie inexcusable inequities in Aboriginal health. Aboriginal health inequities were not included in this review because we chose not to subsume under an umbrella of racial inequities in health the unique history and continuing injustice of Aboriginal health conditions.

We begin our review with a discussion of the concept of race and its relationship to health outcomes and then move to a discussion of the significance of racial inequities in health and the relationship of these inequities to other forms of social inequality. We also examine mortality and morbidity data for various racialized groups in Canada and explore evidence of the role of bias, discrimination, and stereotyping in health-care delivery. Unequal access to medical screening, lack of adequate resources such as translation services, and new and important research on the physiological impact of a racist environment are also explored. This review concludes with a discussion of the limitations of available data on racial inequities in health and health care in Canada. It also surveys the challenges faced by other jurisdictions, such as the United States and Great Britain, in collecting racial data to monitor the extent of such inequities, understand their causes, and address the consequences of unequal access to health care. Finally, it offers recommendations related to the collection of racial data…

Read the entire report here.